ICD-10 Coding for Infectious Colitis(A09, A04.72, A08.3)
Complete ICD-10-CM coding and documentation guide for Infectious Colitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Infectious Colitis
A00-A09Primary Range
Intestinal infectious diseases
This range includes codes for various types of infectious colitis, depending on the causative organism.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A09 | Infectious gastroenteritis and colitis, unspecified | Use when the causative organism is not identified. |
|
| A04.72 | Enterocolitis due to Clostridium difficile, not specified as recurrent | Use when C. difficile is confirmed as the causative organism. |
|
| A08.3 | Viral enteritis | Use when viral etiology, such as CMV, is confirmed. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for infectious colitis
Essential facts and insights about Infectious Colitis
Primary ICD-10-CM Codes for infectious colitis
Decision Criteria
clinical Criteria
- No specific organism identified in lab results.
Applicable To
- Unspecified infectious colitis
Excludes
- Non-infectious colitis (K52.9)
Clinical Validation Requirements
- Clinical presentation of diarrhea, abdominal pain, and fever without specific organism identification.
Code-Specific Risks
- Risk of under-coding if specific organism is identified but not documented.
Coding Notes
- Ensure documentation does not specify an organism; otherwise, use a more specific code.
A04.72 - Enterocolitis due to Clostridium difficile, not specified as recurrent
Use when C. difficile is confirmed as the causative organism.
Applicable To
- C. difficile colitis
Excludes
- Recurrent C. difficile colitis (A04.71)
Clinical Validation Requirements
- Positive stool test for C. difficile toxin B or PCR.
- Clinical symptoms of diarrhea and abdominal pain.
Coding Notes
Ensure documentation specifies C. difficile as the cause.
A08.3 - Viral enteritis
Use when viral etiology, such as CMV, is confirmed.
Applicable To
- CMV colitis
Excludes
- Bacterial colitis (A04.9)
Clinical Validation Requirements
- Biopsy showing CMV inclusions.
- Positive immunohistochemical staining for CMV.
Coding Notes
Ensure biopsy and lab results confirm viral cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Infectious Colitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A09.
Impact
Clinical: Inaccurate treatment and management., Regulatory: Non-compliance with coding standards., Financial: Potential underpayment due to incorrect DRG.
Mitigation Strategy
Ensure lab results are reviewed and documented., Clarify diagnosis with specific organism.
Impact
Reimbursement: Incorrect DRG assignment leading to potential revenue loss., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use A04.72 when C. difficile is confirmed.
Impact
Incorrect coding of infectious colitis can lead to DRG audits.
Mitigation Strategy
Ensure accurate organism identification and documentation.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Infectious Colitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Infectious Colitis
Use these documentation templates to ensure complete and accurate documentation for Infectious Colitis. These templates include all required elements for proper coding and billing.
C. difficile colitis in the emergency department
Specialty: Emergency MedicineRequired Elements
- Patient history of recent antibiotic use.
- Clinical symptoms of diarrhea and abdominal pain.
- Positive stool test for C. difficile.
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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